syahv

By Assoc. Prof. Dr Goh Yi Sheng, Head – Department of Art, Design and Media, School of Arts, Sunway University

It seems to be a “normal” situation in Malaysia that disasters occur whenever it rains. Since the great floods at the end of December last year, urban residents have been terrified by the word “rain” and are still struggling to cope with the tragic situation of frequent floods. When a flood occurs, rescue work will be carried out immediately. Will the elderly be the “priority target” of rescue? The recently published “Research Report on the Experience of the Elderly in Floods” gives the answer, “No”!

This may be very confusing? Elderly people who are unable to escape independently and are in urgent need of rescue are not the primary target of rescuers during floods? A survey was conducted on the physical and mental conditions and problems faced by the elderly before and after the flood. The “Research Report on the Experience of Elderly People in Floods” tells the authorities why rescue units ignore the priority of rescuing the elderly. The reason is: “Insufficient disaster relief experience!”

Rescuers obviously have little idea of the response measures that should be taken by the elderly when facing disasters. Whether it is the government or non-governmental rescue teams, whenever a disaster occurs, they basically adopt the measure of “rescue whoever they meet”.

However, the elderly have a low awareness of disasters and are slower to act, so they need more help than “ordinary people” because the needs and situations faced by the elderly in disasters are different.

The report shows that when floods strike, the problems faced by the elderly include:

●Mobility difficulties

● Long-term medication is required

● Medical care

● Dietary restrictions

● Unwilling to leave home

●Difficulty adapting to new environments (evacuation centers), etc.

The above problems will cause them to face physical and psychological harm.

The research team also pointed out that most disaster response research or the actual help provided by rescue teams is usually given to children. Nowadays, the global population is aging rapidly, but the elderly are often ignored in disasters, which will make rescue work more inefficient.

Respond effectively to disasters

The Future Cities Research Institute (FCRI) is a research institute jointly established by Sunway University and Lancaster University in the UK. The “Study Report on the Experience of Elderly People with Floods” is a research topic based on one of the four major research themes – “Resilient City”. Due to the increasingly serious global warming problem and the overdevelopment of urban areas, disasters have occurred frequently in cities. Therefore, the research topic of “Resilient City” also includes how to quickly recover or effectively respond to disasters when encountering disasters.

The report’s research team consists of four researchers from different disciplinary backgrounds, including Dr. Goh Yi Sheng, a senior lecturer from the Department of Art, Design and Media, and Dr. Catherine Lee Cheng Ean, an Associate Professor from the Department of Communication, both from Sunway University, as well as two researchers from Lancaster University, namely Juliana Sutanto from Indonesia and Hu Yang from China.

The research started in March this year. The research topic is based on the severe floods that occurred in our country in December 2021. By interviewing 60 elderly survivors and government and non-governmental rescue agencies, the needs of the elderly in the face of floods were understood so that Malaysia’s rescue operations can be more efficient and a more friendly, fair and inclusive urban space can be established.

In addition, a Malaysian Disaster Photography Exhibition was held in conjunction with the research report to allow the public to understand and realize the seriousness of the issue.

Recalling the floods and physical and mental trauma

The 60 respondents were all from flood-hit areas in the Klang Valley, including Taman Putra, Hulu Langat, Kuala Selangor and Klang.

Goh Yi Sheng said: “When these elderly people were interviewed, they still felt scared when they recalled the situation at that time, and some even cried while talking about it. This shows how serious the trauma they suffered. They did not expect such a big flood to happen, and they were not prepared at all. They felt very helpless at the time.”

The report lists the situations that the elderly face when floods occur, including:

1. Don’t leave until the worst happens

●“There have been floods before, but the water level is usually very shallow. I didn’t expect it to rise so high that time.”

●“I have eight cats at home and I can’t take them to someone else’s house to stay.”

2. Panic

●“We were all confused and had no idea what was going on.”

●“Many people cannot be contacted and we don’t know whether others have escaped or stayed at home.”

3. Need help to evacuate

●“I am a paraplegic and can only lie in bed and cannot move. The water level keeps rising and I can’t get any help.”

●“My son rowed his boat to save me.”

●“My grandson took us two old people out of the house.”

● “We didn’t see any government personnel coming to assist us when the incident happened. They showed up a few days later, but it was too late.”

4. Fear

●“That was the first time in my life that I felt so scared!”

● “Some non-governmental organizations held dinners in the evacuation centers and sang songs for us, which made us forget our fears and worries for a while.”

5. Need financial assistance

●“The cleanup and repairs afterwards cost nearly RM40,000 in total. This was the worst experience of my life!”

●“The insurance company has not responded yet.”

6. Need help cleaning the house

● “Some people from the temple will come to help with washing the floor, cleaning and tidying up.”

7. Strengthen community cohesion

● “From this experience, we saw that people supported each other regardless of race, and walked hand in hand across bridge after bridge.”

●“We didn’t see any government personnel coming to help. We just had to rely on the residents to help each other.”

Be prepared to evacuate

Catherine Lee pointed out that after experiencing the great flood, most people have a higher awareness of disasters. They will be prepared and put important things in their bags first, and will evacuate quickly if they find something unusual. However, some people hold different ideas. They think that the water level did not rise to the second floor, so they prepare various supplies and move to the second floor for shelter in case of flood.

In addition, some people hope that the government can complete the flood control ditch project and drainage ditch improvement project as soon as possible to prevent floods from happening again.

Goh Yi Sheng also recounted the personal experience of a survivor. An old lady was trapped in the room when the incident happened. As the water level kept rising, she climbed from a chair to the cupboard and kept shouting for help. An elderly man living alone next door who happened to be taking shelter on the roof heard the cry for help and rushed over to break the tiles on the roof and successfully rescued the old lady.

“After this terrible flood, now whenever it rains and thunders, they will immediately check the water level in the ditch and can’t sleep at night.”

In addition, Catherine Lee also added that evacuation centers should also be equipped with basic medicines for emergencies, and food supplies must be sufficient.

“Elderly care experts say that if the elderly do not eat or eat very little, they will suffer from malnutrition and hallucinations, and become incoherent. In addition to material assistance, respondents also pointed out that they need spiritual support, such as someone to chat with them or listen to their experiences, which can temporarily relieve their mood and put aside their worries.”

Three major rescue challenges

In terms of disaster response, the research team spoke to firefighters and members of Congress as well as non-governmental organizations in the relevant areas.

Government agencies pointed out that the rescue challenges they faced included:

·Residents are not prepared (especially in areas where floods have rarely or never occurred);

Major floods that exceed the capacity of rescue operations;

·Disruption of communication networks and lack of effective communication channels between the government and non-governmental organizations.

Government units said that since there is no disaster relief policy specifically formulated for the elderly, they need to rely on the assistance of community leaders or community heads.

“While carrying out rescue work, we must also consider the safety of firefighters. If there is no one to lead the way, firefighters can only blindly look for survivors, which is even more inefficient. Therefore, we need to rely on village heads or community leaders to lead the way, determine the priority targets and house locations, and carry out rescue work in a targeted manner.”

Prioritize before rescue

In addition, they also suggested that the National Disaster Management Agency (NADMA), regional fire bureaus and community leaders should work together to establish a system to record the information of every household in the community so that priority targets can be rescued first during disaster relief. For example, focus on low-lying houses first, followed by houses with elderly people, and classify the elderly according to their conditions, such as poor health, bedridden, living alone, living with an elderly spouse, etc., so as to prioritize before rescue.

As for non-governmental organizations, the rescue challenges they face include the reluctance of the elderly to leave, their medical conditions and malnutrition, and the lack of trained volunteer teams. They admit that some volunteer teams have no experience in helping the elderly escape, which is indeed more difficult, and they also observe that the elderly are not the first group to be taken care of.

According to the non-governmental rescue team, they were not allowed to enter the disaster area for rescue without training. Therefore, they asked the relevant government units to provide training and establish an effective cooperation model with non-governmental units in order to prepare for future disaster relief and increase disaster relief manpower. Otherwise, even if there are people who can help, they will not be allowed to enter the disaster area.

“They believe that the most important thing is to instill the correct disaster awareness at an early stage among the elderly who are more mobile at the local level, and then have them spread it to others to prepare for any possibility of facing natural disasters.”

*First Published in e-Nanyang on 23rd November 2022

By Dr. Mageswari Ranjanthran, Lecturer, Sunway Business School, Sunway University

Do you have a friend or family member with inflammatory bowel disease? Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease, are chronic inflammatory disorders of the gastrointestinal tract caused by interactions between genetic, environmental, immunological and microbial factors. While the incidence and prevalence of IBD in Asian populations were relatively lower than those in Western countries, they appear to be gradually increasing. Conjointly, paediatric inflammatory bowel disease (PIBD) in Asia, once considered a rare entity, has seen a sharp increase in incidence over the preceding decade. This epidemiological trend has been consistently observed in both the adult and paediatric Asian populations.

In a serious situation, an unpleasant and rather debilitating disease can turn into a dangerous and life-threatening one with peritonitis. This would then be a surgical emergency. Crohn’s disease can affect any part of the digestive tract and can affect absorption of food and nutrients. The exact cause of IBD is unknown, but IBD is the result of a weakened immune system. Possible causes are: The immune system responds incorrectly to environmental triggers, such as a virus or bacteria, which causes inflammation of the gastrointestinal tract. There also appears to be a genetic component.

Still, IBD is a perplexing group of diseases that tends to be difficult to diagnose and treat. Researchers have collected a significant amount of information concerning the genetics, distribution and contributing environmental factors for IBD. Overall, IBD affects people of all genetic backgrounds, but it seems to have a higher prevalence in Western and developing countries. It also tends to be diagnosed most commonly in adolescents and young adults. Although Crohn’s disease and UC do appear to run in families, the connection is not always direct (such as from parent to child). The risk of inheriting the disorder is a complex process with many factors, influenced by both one’s genetic predisposition and environment. IBD is often considered a disease of adolescents and young adults because it is most commonly first diagnosed in people between the ages of 15 and 25 (at least one source indicates peak incidence to be between the ages of 15 and 35 years).

A strong support system is crucial for people with IBD. Yet, living with IBD can complicate relationships with family, friends and significant others. Life with IBD can be a rollercoaster of physical, emotional, social and financial complications, and loved ones often go along for the ride.

The majority of patients (81%) expressed feelings of fatigue, weakness and being worn out in their daily lives during times of flare-up; this percentage was reduced to 61% during remission. Most patients (68%) felt stressed and were psychologically affected even during remission. The predominant symptoms of IBD are diarrhoea, abdominal pain, gastrointestinal bleeding, weight loss, malnutrition and fatigue, which can substantially affect a patient’s quality of life, owing largely to the psychosocial impact of symptoms.

Whether the patient is newly diagnosed or has lived with IBD for many years, it is important to understand the possible impact of IBD on day-to-day life so that the patient can make positive changes to manage the condition better.

IBD has a significant impact on daily life, including work, education, and social relationships. Living with either UC or Crohn’s disease means patients need to balance their condition with a healthy lifestyle. This might mean changes in diet, lifestyle and relationships. IBD can sometimes affect many aspects of life. Even if you feel relatively “well” most of the time, a chronic condition can sometimes feel overwhelming. You may also feel worried about things such as the effect of the either UC or Crohn’s disease on your personal and social life or on your ability to study and work, as well as the potential financial implications.

Preventive health measures can avert morbidity and improve the quality of life of patients with IBD.

A healthy lifestyle matters for IBD patients

Taking medication is just one part of managing IBD. Both UC and Crohn’s disease will react well to positive changes in lifestyle, leading to better symptom control and fewer complications. Lifestyle changes include diet and nutrition planning, exercise, emotional well-being and avoiding smoking and alcohol.

Doctors recommend a daily diet that includes eggs, yogurt, fruit, vegetables, legumes, brown rice, miso and pickled vegetables, along with the occasional glass of milk and green tea. This diet calls for limited animal proteins — fish once a week and meat just once every two weeks. Low-impact or moderate exercise is encouraged for IBD patients. Low-impact activities include, but are not limited to, brisk walking, cycling, swimming, yoga, elliptical and rowing. Low-impact exercise does not mean it is easy or ineffective for IBD patients who are taking small steps towards a healthy lifestyle.

Although emotional upset does not cause IBD itself, in some people, stressful situations or strong emotions may lead to flare-ups of symptoms. This does not mean, however, that everyone who has stress will experience a flare-up, but if you are someone with IBD who knows that stress can be problematic, it is helpful to be prepared and learn stress-management techniques. Stress can be a constant presence in life: Changing jobs, getting married, moving, a death in the family, raising children or caring for elderly parents can cause stress. Simply having a chronic condition can cause IBD. Even minor annoyances of life can be stressful. As a human being, it is impossible to completely eliminate stress-producing events, but it may be possible to change the reaction to stress causes and situations.

Therefore, stress management and switching to a healthy lifestyle are the best practice for preventing IBD. Through tuning in to a healthy body, making healthy choices for their emotional well-being and working closely with health professionals, patients can enhance their quality of life as they live with IBD.

This project is funded by Future Cities Research Institute — Liveable Cities Seed Corn Grant between Lancaster University and Sunway University for ‘Inflammatory Bowel Disease: An emerging tale of two continents with an urgent need for early resolution’ by Prof Roger Pickup and Dr Mageswari Ranjanthran, as principal investigator, and Dr Ooi Pei Boon.

*First Published in The Edge on 11th July 2022

Author: syahv

Rescue work is inefficient and floods strike and sacrifice the elderly?